Looking after your mental health in prison: a guide for male prisoners

This content discusses substance abuse or addiction (which may include mentions of alcohol or drug use), depression, anxiety and death or bereavement, which some people may find triggering.

This booklet discusses ways to look after your mental health in a prison setting.

“I also had to understand and accept that I was in prison because of my own actions and consequences. The consequence was a prison sentence. Yet, even though I am a prisoner, I can still achieve and make a success of my life.”

Mental health is about how you think and feel and your ability to deal with ups and downs. Looking after your mental health in prison can help you:

• Cope better with life in the prison environment
• Make positive changes to improve your well-being
• Build better support networks with family, other inmates and professionals who can help

Everyone’s mental health fluctuates. We all have times when we feel down, stressed or frightened. Most of the time, these feelings pass, but sometimes they develop into a more serious problem.

Self-harm is a serious problem in prison. Although the statistics for self-harm are higher for women than men in prison, you can ask for support from the mental health team if self-harm is an issue for you. 

"Jail can be scary, the unfamiliar surroundings, the loud noises, a routine that revolves around time….”

There are lots of factors that affect our mental health. Two areas that greatly affect your mental health are bereavement and substance abuse.

Bereavement and loss

Prison staff tell us that they are aware that when a prisoner experiences a bereavement, not enough is done. One of the greatest hardships of prison is missing out on family events and the most difficult can be the death and funeral of a loved one.

There are a number of special licences that may be possible for you to access in order to visit a dying relative or attend a funeral. Please ask staff to see if you are able to apply for such a licence.

Alternatively, you may be able to attend a funeral or visit a dying relative under escort. This means having a minimum of two officers with you and may include the use of restraints if the risk assessment says that it’s necessary.

If you do experience a bereavement, you should be offered pastoral care from the chaplain who can support you during this difficult time. It’s important to request that the chaplain visits you again if that will be helpful.

Sharing the news with people you trust is important, whether this means talking to officers, prisoners, Listeners or calling the Samaritans. Try not to bottle up the news, as that is likely to cause more harm than good.

If you are struggling after a bereavement you should ask for support. For further information you can contact the Prison Reform Trust.

Substance abuse

It has been widely documented that there are many drugs circulating in prisons. This represents challenges both if you are someone who has regularly used drugs in the past or someone who hasn’t used drugs before.

One way of thinking about this is that you are likely to feel a great deal worse after taking drugs, compared to before. The synthetic marijuana drug, Spice or K2, is extremely addictive and has horrendous side effects such as vomiting and seizures.

The status of drugs is complex in the prison system. If you are able to, it is best to say “no” and keep saying “no” to drugs.

For further information for you and/or your family and friends the following organisations may be of help:

• Adfam
• Alcoholics Anonymous
• Release
• Frank

The following tips for looking after your mental health in prison have come from prisoners themselves as well as researchers working in prison.

Tip 1: Take care of yourself

“I have no one. No one sits with me or talks to me on the wing.”

When people feel sad or depressed, they can neglect themselves. Keeping regular hygiene routines such as washing, shaving, and wearing clean clothes is often the first thing to do when we struggle with our mental health.

Prisoners tell us that it’s hard to get motivated to care for their appearance when they feel low. Being unkempt and uncared for can affect how other people think of us and lead to an even stronger sense of isolation.

Building a regular hygiene routine can help bring consistency to life in a prison environment. Showering and shaving every day are simple goals that make a big difference to our self-esteem. These can go a long way to protecting ourselves from being overwhelmed by poor mental health.

The same thing goes for eating a healthy balanced diet. Choosing what you eat may be one of the few things that you have control over in prison, so make the most of it:

• Eat three regular meals a day even when it’s the last thing you feel like doing
• Drink plenty of water
• Include lots of different types of fruit and vegetables
• Choose a ‘Healthy Option’ at least once a day
• Eat fewer high-sugar foods

A diet that’s good for your physical health is also good for your mental health. If you would like to find out more, ask the prison library or Healthcare if they can print information from the following links:

• Mind booklet: Food and mental health
• British Dietetic Association Factsheet: Food and mood: Food fact sheet

Tip 2: A problem shared is a problem halved

“When I first came to prison I was scared and I didn’t know which way to turn, who I could trust, what I had to do, no one helped me. I felt lost.”

Asking for support and help in a new situation is not a sign of weakness. Finding out about routines, rules and what’s available to make life easier in prison is very important for your well-being. It may be surprising that for many prisoners, time in prison is the first opportunity they have had to turn their lives around, improve their health and access the services they need.

Talking about personal thoughts and feelings isn’t easy. Prisoners tell us that finding someone they trust to talk to can be difficult. Talking about feelings can be hard, so it may be useful to plan what you want to say in advance. Talk to Health Care, the Chaplain or Wing Staff to support you.

“I had a problem and I shared it with these guys last week and we all talked about the different ways of dealing with it. That was really useful.”

Talking can be a way to cope with a problem you have been carrying in your head for a while. In many prisons, prisoners have been trained as Listeners and offer a confidential service. Talking to someone experiencing the same situation can help you feel less isolated, and feeling listened to can help you feel more supported.

“Now I ain’t saying I am cured and life is great, because it is far from it but I know there is support and if you are feeling low or think what’s the point anymore- don’t suffer in silence. Speak to a listener, Chaplain or support mentor because these people are there whenever you need them. So if it is early hours and you need to talk, remember to press your bell and ask for a listener.”

Tip 3: Get active

“Keeping yourself busy is key. I feel better when I am busy.”

Regular physical activity and exercise can help your physical and mental health.

Researchers have found that even moderate exercise in a prison setting positively affects mental health and effectively reduces the risk of depression¹.

You might want to visit the gym and exercise facilities. It doesn’t have to be sports-related exercise, though – it could be gardening or animal husbandry. Anything that gets you moving can make you feel better.

If you are slightly older, find out if the prison offers any special ‘Wellman’ programmes to help you manage weight, blood pressure, and any long-term health conditions.

Sometimes prisoners have to spend up to 23 hours a day in their cells, so learning individual exercises that can be carried out in limited spaces can be helpful.

Set achievable goals such as getting a little fitter or losing weight. Working towards goals (see tip 7) can help you to focus, and achieving them can help to improve your self-esteem.

“I am going to the gym and have joined the outdoor walking club. I still set goals in relation to the gym.”

There are useful booklets and videos available that tell you more about the benefits of exercise and help you create a simple exercise routine.

Ask your prison library if they can access them for you, for example How to look after your mental health using exercise.

Tip 4: Learn something new

“Now I am learning to read and write so I can send a letter to my wife in my own handwriting.”

The one thing that prisoners have is time. This time can be taken up with worry or feeling angry. It can also provide the opportunity to learn a new skill or develop an interest. Learning can help build confidence and a sense of self-worth. Learning can be good for our well-being, especially when it’s something that you want to do and comes at a stage when you are ready to benefit from it.

There may be more opportunities to learn new skills in prison than you might expect. This might be cooking in the kitchen or gardening. Some prisons have peer mentoring schemes so you could become a peer mentor or think about career development. You could also improve your reading or writing and gain some qualifications. Or you could become a listener or mentor.

Learning something new or developing a skill can take you away from your current surroundings. This can have a positive impact on your mental health.

“Since being in here, I have done my Art GCSE and Art A level. Before I came in here, I couldn’t read or write and so I was so chuffed with the A* at GCSE.”

Tip 5: Think more positively

“I am quite a negative person but now I look on the bright side. I am here (in prison) for six years, six months but I am not here as long as others. That is the way I look at it.”

In difficult situations, your thoughts are more likely to be negative. This can lead to feeling anxious, guilty or angry. This negative thinking can become habitual, particularly when life is challenging.

Over time this can lead to depression or become a barrier to making changes and improvements to our lives.

It’s important to challenge negative thoughts to maintain our mental health. Developing a more positive thinking habit takes time but can make a difference to the way you feel and behave. The following can help you to change negative thought patterns to become more positive:

Become more self-aware

Try to identify and understand where the negative thoughts come from. This might be directly from prison, but it is also likely that they result from past experiences.

Become more self-disciplined

Be aware of when you have negative thoughts and how they impact on you. Try to make a positive decision to make a change to improve.

Reframe things in a more positive way

Positive statements can encourage us to cope in difficult circumstances. Try to build up a list of positive phrases that you can use. Here are some ideas from other prisoners:

• I am worth more than I think
• I have survived before. I will survive now
• There is always a point
• I can learn from this
• I can laugh
• I don’t need to rush. I can take things slowly

Become more focused on solutions

When things get difficult, it’s helpful to focus on the solution and not the problem. Be aware that there are some things you can control and others can’t. Try not to focus too much on things you have no control over.

An example one prisoner gave was that rather than getting upset by a lockdown preventing him from going to the gym, he used the time to do a workout in his cell instead.

Living Life to the Full has lots of really useful worksheets to help you work with these issues. Ask the prison library or Healthcare if they can print some for you to use.

Tip 6: Think about reducing stress through meditation, mindfulness and relaxation

“In prison you have a lot of time behind the door...”

Research has shown that regular meditation can help reduce stress levels in prisoners², particularly if stress has been maintained over a long period of time.

“Mindfulness is a way of paying attention to the present moment, using techniques like meditation, breathing and yoga. It helps us become more aware of our thoughts and feelings so that, instead of being overwhelmed by them, we’re better able to manage them.”³

Mindfulness is a simple practice to learn that has also been shown to have positive benefits in combating stress, anxiety and depression, as well as physical problems such as high blood pressure and chronic pain.

You can practice mindfulness alone or in a group. There are several courses run by trained mindfulness coaches in some prisons now, but books and audio courses are also available. Check your prison library or ask the Health Care team.

Here is a one-minute mindfulness breathing exercise you can practice anywhere at any time:

Take a minute to observe your breathing. Breathe naturally and notice the time between each breath in and out. When your mind wanders, just gently bring it back to breathing. You can continue for longer than one minute if you want to.

If you find mindfulness difficult, you can also use relaxation techniques to reduce stress. These can help to:

• slow your heart rate down
• make your breathing slower and deeper
• relax muscles
• lower blood pressure
• increase blood flow to the brain

These physical responses will also help you to feel calmer and less anxious or agitated. You can practice relaxation in a group or alone. Take a look at our useful booklet, “How to look after your mental health using Mindfulness”, which the prison library or Healthcare could download for you.

Tip 7: Begin to make plans

“I now draw pictures for other inmates so that they can send it to their loved ones in their letters, for their kids or for birthdays.”

Setting goals may seem impossible in prison, but achieving small things can make a real difference to your well-being. Having a goal to work towards can build your sense of self-worth and confidence. Here are some examples of goals below that prisoners have set. These may depend on what’s available in the prison:

• To look after myself and shower every day
• To learn a language
• To become a Listener
• To maintain my job in the garden
• To control my anger
• To write a letter every week to my family and friends
• To attend art classes and learn how to draw
• To learn how to play the guitar

Having a clear sense of what you want to achieve can give you a focus in prison. Goal-setting links well with positive thinking and being solution-focused.

Start practising with a ‘Quick Win’ goal, which you can achieve within the next week. This will help you understand what motivates you and will also help build your confidence. For example, this could be cleaning your teeth at the same time each day.

During this time, think about one or two bigger goals you would like to achieve in the medium and long term. You should try and make these SMART goals:

• Make it Specific - What do you want to do?
• Make it Measurable - How will you know when you have completed your goal? How can you measure it? Is it possible to get it done?
• Make it Attainable - How can the goal be completed? What steps will you take?
• Make it Relevant - Can you explain why this goal is important to you?
• Make it Time-bound - It can be helpful to set yourself a time limit to complete the goal.

Break these down into smaller ‘step-by-step’ goals. Breaking your bigger goal into smaller achievable steps makes it more manageable and helps you see your progress.

If you want, let people know what you hope to achieve and accept their encouragement and support.

“Get back to the wife and kids and never look back. I want to be anger free and learn to read.”

Tip 8: Try to keep in touch

“I couldn’t believe how hard it was for my family and all I did was worry about them, being away from them made me sink into a dark place. But they are the ones who made me strong”

Maintaining contact with friends and loved ones outside of prison can be very difficult. You may feel that they don’t want anything to do with you or that you have let them down, but you (and them) need to keep communication lines open. Maintaining regular contact with people in the outside community can help you survive the day-to-day stress of being in prison. It keeps you in touch with the outside world and can inspire you to work towards a different life in the future.

Research recognises that regular contact with family and friends can play an important role in helping prisoners through their sentences, including improving mental well-being for both prisoners and their families.⁴

Find out about visiting times and visitors' application process as soon as possible. Establishing regular visits can give you something to look forward to. Prisons often set up family visit days to help keep prisoners and their children in touch. Charities such as Barnardo’s work with prisons in the UK to support prisoners’ families to maintain good contact with each other.

Remember that your family may find it difficult to get to visit for all sorts of reasons, such as distance and cost of travel. It is important to respect and understand what they might be going through. Find out if your prison offers family support services and do make use of them.

It is still possible to have regular visitors even if you have lost contact with your family or have no family and friends that can visit. The National Association of Prison Visitors has volunteers who will visit regularly. The aim of the association is to extend the hand of friendship and promote the value of friendship. They help prisoners keep a link with the outside and a sense of belonging to a community.

Here is a quote from their website:

“Having a visitor means a lot. It means that someone from outside is bothered enough about me to come and visit.”

Tip 9: Aim to build more positive relationships

“I have no-one. No-one sits with me or talks to me on the wing.”

Being ‘inside’ means living closely with many different types of people, such as other prisoners and prison officers. This can be very stressful and intimidating. Even though it’s a crowded and noisy environment with little privacy, it can be very lonely and isolating.

Having good relationships can help our physical and mental health. A supporting relationship enhances our well-being and can be a buffer from the negative effects of stress in our lives.⁵

A positive relationship needs time and attention given to it. If you want someone to be there for you and listen to you, you need to do the same in return.

• An important place to start is building a positive relationship with yourself. Being kind to yourself regularly is one of the best things you can do for your mental well-being. For example, having personal time to do something you choose like reading, meditating or drawing.
• We have already mentioned the value of keeping in contact with family and friends and how that can keep you connected to the world outside.
• Other inmates can be a valuable source of peer support. They understand what you are going through and may have useful tips that can help you survive daily. One way of connecting with other like-minded prisoners is to join a course or activity that interests you.

“Now I am friends with Toby and Derek…we can communicate with each other because they have been on the same course. We have formed a mini-membership club because we have some things in common with other people who have been on the course.”

• You may not be able to have a friendship with the prison staff, but if you can connect positively with the staff and professionals, it can bring benefits of support and guidance when you need it.

Being around positive people can make us happier. Equally, our well-being can be negatively affected by harmful relationships, leaving us unhappy.

“I am a highly distressed person so I bottle it up a lot, so it was good to talk in a group. I keep talking to people now.”

Here are some features of positive and negative relationships:

• Good relationship - caring, listening, equal, kind supportive
• A good enough relationship - realistic, steady, a compromise, just enough, informative
• Poor relationship - ignoring, stressful, blaming, controlling, draining, distant, patronising, critical, manipulative

Tip 10: Doing good does you good

“It makes me feel better that people recognise me for my artwork”

Doing good indeed feels good, but this is actually backed up by research.⁶

Being a part of a social network leads to a feeling of belonging. Face-to-face activities such as volunteering can help reduce loneliness and isolation.

Helping others in need, especially those who are less fortunate than yourself, can provide a real sense of perspective. This can enable you to stop focusing on what you feel you are missing and help you to feel more positive.

Being kind can improve confidence, happiness and optimism. It can also contribute to a more positive community. There are also physical benefits, such as; reducing stress and decreasing feelings of anger and hostility, and studies show that helping others can even help us live longer!

It may seem hard to think of ways of doing good whilst in prison, so here are some suggestions:

• Connect with a charity or helping organisation. Maybe you could become a Listener, Healthcare Champion or peer
  supporter
• Teach another inmate a skill that you have, for example, model-making, playing guitar, literacy
• Spend time with someone who is going through difficulties

“People helped me with what to do and what to say. And by advising me it gave me strength to respond and challenge. This has helped me and people stopped picking on me.”

• Write to family or friends to tell them you love them
• Send a thank-you note to someone who has helped

Regular small acts of kindness can positively change your attitude to life. You may also discover a new direction like the prisoner in this quote below:

“I want to work with the homeless – I used to run pubs and now I want to run a café for the homeless, where people can drop in and keep warm.”

Useful information

• Samaritans
• Prisoners Advice Service
• Prison Reform Trust

References

1. Battaglia, C et al (2015) Participation in 9 month physical exercise programme enhances psychological wellbeing in a prison population. Criminal Behaviour and Mental Health 25, 343-354.
2. Nidich, S et al (2016) Reduced trauma symptoms and perceived stress in male prison inmates through the transcendental meditation program: A randomized controlled trial. The Permanente Journal/Perm 2016 Fall(4); 16- 007 Accessed online: http//dx.doi.org/10.7812/ TPP/16-007.
3. Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your mind to face stress, pain and illness. New York: Deli.
4. Hairston, CF (1991)Family Ties, During Imprisonment: Important to Whom and for What? Journal of Sociology and Social Welfare. 18(1) 87-104.
5. Brooke C, Collins N. (2014)A theoretical perspective on thriving through relationships. Personality and Psychology Review (19) 113-147.
6. Robotham D, et al. (2012) Doing Good? Altruism and wellbeing in an age of austerity. Mental Health Foundation.

If you feel affected by the content you have read, please see our get help page for support.